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Sleep Apnea is a disorder of breathing during
sleep. Typically it is accompanied by loud snoring. Apnea during sleep consist
of brief periods throughout the night in which breathing stops. People with
sleep apnea do not get enough oxygen during sleep. There are 2 major
types. Obstructive and Central Sleep Apnea . . .
Snoring is the vibration of respiratory
structures and the resulting sound, due to obstructed air movement during
breathing while sleeping. In some cases the sound may be soft, but in other
cases, it can be rather loud and quite unpleasant. Generally speaking, the
structures involved are the uvula and soft palate. The irregular airflow is
caused by a blockage.
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Sleep Apnea is a disorder of
breathing during sleep. Typically it is accompanied by loud snoring. Apnea
during sleep consist of brief periods throughout the night in which breathing
stops. People with sleep apnea do not get enough oxygen during sleep. There are
2 major types.
Obstructive Sleep
Apnea is the most common type and is due
to an obstruction in the throat during sleep. Bed partners notice pauses approx.
10 to 60 seconds between loud snores. The narrowing of the upper airway can be a
result of several factors including inherent physical characteristics, excess
weight, and alcohol consumption before sleep.
Central Sleep
Apnea - caused by a delay in the signal
from the brain to breath. With both obstructive and central apnea you must wake
up briefly to breathe sometimes hundreds of times during the night. Usually
there is no memory of these brief awakenings.
What is Sleep
Apnea?
Obstructive Sleep Apnea Syndrome is
characterized by repetitive episodes of upper airway obstruction that occur
during sleep, usually associated with a reduction in blood oxygen saturation. In
other words, the airway becomes obstructioned at several possible sites. The
upper airway can be obstructed by excesses tissue in the airway, large tonsils,
a large tongue and usually includes the airway muscles relaxing and collapsing
when asleep. Another site of obstruction can be the nasal passages. Sometimes
the structure of the jaw and airway can be a factor in sleep
apnea.
There is also Central Sleep Apnea.
It also is characterized by the cessation of breath due to a lack of effort in
breathing during sleep. Central Sleep Apnea is not as common as OSA and is more
difficult to diagnose Typically it is due to some neuromuscular problem but
other sources could be the cause.
Most Common
Symptoms:
Loud Snoring Waking up unrefreshed and having trouble
staying awakeWaking up with headaches
Waking up during the night with the
sensation of choking Waking up sweating Frequent trips to the bathroom during
the night Insomnia - problem staying asleep
Being overweight but not necessary
Waking and gasping for air
Is this a serious
condition?
It is a potentially life-threatening
condition that may require immediate medical attention. The risks of undiagnosed
obstructive sleep apnea include heart attacks, strokes, impotence, irregular
heartbeat, high blood pressure and heart disease. In addition, obstructive sleep
apnea causes daytime sleepiness that can result in accidents, lost productivity
and interpersonal relationship problems. The severity of the symptoms may be
mild, moderate or severe.
How does the doctor determine if
you have OSA?
A sleep test, called polysomnography
is usually done to diagnose sleep apnea. There are two kinds of polysomnograms.
An overnight polysomnography test involves monitoring brain waves, muscle
tension, eye movement, respiration, oxygen level in the blood and audio
monitoring. (for snoring, gasping, etc.) The second kind of polysomnography test
is a home monitoring test. A Sleep Technologist hooks you up to all the
electrodes and instructs you on how to record your sleep with a computerized
polysomnograph that you take home and return in the morning. They are painless
tests that are usually covered by insurance.
How is Sleep Apnea
Treated?
Mild Sleep Apnea is usually treated by some
behavioral changes. Losing weight, sleeping on your side are often recommended.
There are oral mouth devices (that help keep the airway open) on the market that
may help to reduce snoring in three different ways. Some devices (1) bring the
jaw forward or (2) elevate the soft palate or (3) retain the tongue (from
falling back in the airway and blocking breathing). Sleep Apnea is a progressive
condition (gets worse as you age) and should not be taken
lightly.
Moderate to severe Sleep
Apnea is usually treated with a C-PAP
(continuous positive airway pressure). CPAP is a machine that blows air into
your nose via a nose mask, keeping the airway open and unobstructed. For more
severe apnea, there is a Bi-level (Bi-PAP) machine. The BI-level machine is
different in that it blows air at two different pressures. When a person
inhales, the pressure is higher and in exhaling, the pressure is lower. Your
sleep doctor will "prescribe" your pressure and a home healthcare company will
set it up and provide training in its use and maintenance.
Some people have facial
deformities that may cause the sleep apnea. It
simply may be that their jaw is smaller than it should be or they could have a
smaller opening at the back of the throat. Some people have enlarged tonsils, a
large tongue or some other tissues partially blocking the airway. Fixing a
deviated septum may help to open the nasal passages. Removing the tonsils and
adenoids or polyps may help also. Children are much more likely to have their
tonsils and adenoids removed..
There are several other surgical
treatments. Usually a surgeon will ask the
patient to be on CPAP for at least month to see if they get better. If CPAP
cannot help then surgery is probably not the right thing to do. These treatments
include, removing excess tissue to clear the airway, moving the tongue forward,
and moving the upper and lower jaw forward. There and other procedures try to
increase the size of the upper airway.
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California
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